1. Technical Field
The application relates to a surgical apparatus and more particularly to a surgical apparatus for forming a hole in a vessel wall.
2. Background of Related Art
In heart bypass surgery, it is necessary to attach a graft to the patient's aorta to divert blood flow away from the constricted vessel so it instead flows from the aorta through the graft. Typically, a scalpel incision is made in the aorta and an instrument, commonly known as an aortic punch, is inserted into the incision to punch a circular hole. The graft can then be attached to the aorta at the site of the circular hole. Examples of aortic punch instruments are disclosed in U.S. Pat. No. 4,018,228 to Goosen and U.S. Pat. No. 4,216,776 to Downie. Since the aorta is a region of relatively high pressure blood flow, the initial scalpel incision causes a great deal of bleeding which can obstruct the site and inhibit insertion of the aortic punch. Also, by adversely affecting visibility, the time required to perform the surgical procedure is increased.
To reduce the amount of blood caused by the initial scalpel incision, some surgeons clamp the portion of the aorta adjacent the region where the scalpel incision is to be made. This reduces the blood flow when the surgeon makes the incision. However, since it is likely that there is plaque buildup on the inside wall of the aorta, clamping the aorta could detach the plaque from the wall, sending it into the patient's bloodstream which can cause a stroke or other harm to the patient.
The need therefore exists for an instrument and method to facilitate insertion of an aortic punch without requiring clamping the aorta.